Wounded Healers: Caz (Mental Health 360º)

Caz of Mental Health 360º is the first person to be featured in the wounded healer interview series, featuring people with significant mental health challenges who also work in a mental health helping role with others.

Tell us a bit about you, the helping field you’re in, and the mental health challenges you’ve faced.

I was a mental health nurse in various settings before I became a Ward Manager. When I was only fifty, I was struck down with a rare neurological disorder called Transverse Myelitis (TM), which meant I couldn’t walk ‘normally’ for a while and I was left with many of my current symptoms. I was embarrassed at being disabled and felt so very angry, raging that I was left like this – I was still only young. After one year off work, I was encouraged to take medical retirement. I’d had the best job ever and was previously fitter than most youngsters. I hated the world and everyone in it.

I became depressed, anxious and had panic attacks round the clock. I wanted to be dead rather than live like this. I continually imagined myself leaping from my tenth-floor window, jumping onto the railway across the road or stumbling in front of a speeding car. Fortunately, the neuro team were able to put some counselling in place and in time the panic attacks stopped, the anxiety lessened, and medication helped the depression a little.

After a couple of years my partner started to take me on motorcycle trips – with three huge panniers on the back of the bike that sat like an armchair, holding me up and in. I loved it, the freedom, the wind and sun on my face. However, on this one trip round beautiful northern Italy, I started thinking how I wanted throw myself off the bike at 100 mph, making it look like an accident rather than suicide.

The thoughts came from nowhere. I mean, look at me, travelling round Europe during the summer, stopping wherever we pleased; by beautiful lakes or mountains, eating olives, cheeses and other local delicacies, drinking fine wines. What the hell was wrong with me? We cut the trip short as I just wanted to be home where, apart from the window, I felt safer.

What made you decide to go into your helping field?  Did your mental health challenges play a role?

Following the breakdown of my relationship with my sons’ father when I was thirtyish, I had a mental health ‘breakdown’ – I say that because that’s just how I felt – emotionally and mentally broken. I had anxiety, panic attacks, an eating disorder and a severe depression which led to psychosis. I was seeing things other people couldn’t see; the ugly red horns on my forehead made me feel sick when I looked in a mirror. I was hearing ugly voices other people couldn’t hear and the tiny insects crawling under my skin, had me clawing at my arms and legs with revulsion.

My GP knew my family well, and after a time, he noticed my weight loss and following a lengthy chat, he was able to get me immediate counselling. My issues were complex and I remained in therapy for over three years.

As therapy neared the end, I was facing redundancy from my part-time job as Human Resources Manager, which gave me the opportunity to return to study. I didn’t know what I wanted to study but one day, reading through our local paper I saw an advert for nursing students, which didn’t so much interest me. However, there was about five lines talking about mental health nursing and, as they say, the rest is history. Having had my own mental health illness and the fact that it ran in my family definitely influenced my decision to go into the field of mental health nursing.

How have your own mental health challenges influenced the helping work you do?

I’m not sure I could have done my job as well as I did without having had my own personal experiences. I used to be more judgemental and less compassionate and having gone through my own experience enabled real empathy with patients. I truly understood the impact of trauma on someone’s mental health, their relationships and their world. I had a genuine interest in their story; how they got to where they are now, and how best I could support them.

Do you think you’re a more effective helper because of your own mental health challenges?  How so?

Oh, definitely. Because of my own challenges, I knew how important it was to feel heard and listened to. I realised the importance of having your feelings truly validated. I’d particularly learned how to listen effectively, giving patients opportunities to open up, to tell their story, possibly for the first time.

My own experiences of recovery helped me support patients in theirs, understanding what might help, what support they needed and how they can help themselves. I understood how nursing isn’t about doing for or to a patient, it’s about supporting patients and encouraging them to participate in their own recovery. Moreover, I understood the need to improve the quality of care and how to contribute to positive patient experiences.

Have you chosen to share your own mental health challenges with any of your patients/clients?  What influenced that choice?

Yes, but not in an out and out way. It was more subtle. I think I’d learned to change the way I thought and spoke. I used words like “When we’re unwell”, “What does depression mean to us?” or “our ward”, and “our staff” – it was inclusive. My new intra and interpersonal skills like being compassionate, non-judgemental and empathic often gave patients the impression that I’d been where they were. They quite often guessed and then I’d be happy to share that “yes, I’ve been there”.

I’d only tell them if they asked me, but as a rule, I wouldn’t offer the information. In nursing we have boundaries and ethics to consider – all I would say to new nurses is “it is okay to use self-disclosure, as long as it’s for the benefit of the patient and not the nurse.” Also, never tell a patient anything you wouldn’t tell the rest of the world, so to speak. Because when patients are unwell, they might slip up tell your colleagues, fellow-patients or visitors.

Has your training or experience in your helping field changed how you approach your own illness or mental health challenges?

Yes, definitely. Once I’d qualified and went to work on the wards, I just didn’t know what to do or say, particularly to patients with psychosis – I didn’t know how to help. I felt like a fraud, so I applied for and had access to another five years part-time study through the Trust I worked for. I also did more training in my own time and instructed large groups of people in Mental Health First Aid. By Continuing Professional Development I’ve been able to build up a comprehensive ‘toolbox’ of skills and interventions that I could apply to myself.

It might sound odd, because while I have all these skills, as a nurse, as a CBT Therapist for people with schizophrenia and providing both Early and Family interventions, I still have episodes of medication-resistant depression. There are times where I’m fatigued due to my physical symptoms of TM and I don’t have the energy or motivation to help myself, which are symptoms of the depression.

What advice would you give to someone who has faced mental illness or other mental health challenges and is thinking about entering your helping field?

I would say, get yourself better first and foremost. If you can’t look after yourself, how can you be expected to look after others effectively?

You must ensure you are well enough to be able to commit to this kind of work, otherwise it’s not being fair to patients – they need commitment and continuity of care.

Mental health patients have generally had such chaotic lives, with people not caring for them or about them, and have been abandoned when they’re at their lowest. If you intend to go into this as a qualified and professional nurse, look after your own mental health.

Mental health nursing is the most amazing job ever; it’s an honour to work with so many damaged but often inspiring people, it’s so rewarding, satisfying and very humbling However, you’re often under a lot of pressure and it can be really tough on the wards both physically and mentally – so it would be easy to buckle and become unwell again under such pressure.

That aside, I would love to see more kind, caring and compassionate and empathic mental health nurses on our wards.

Thanks so much Caz for doing this interview!

You can find Caz on her blog Mental Health 360º.